Tatalaksana Ventilasi Pada Pasien Coronavirus Disease 2019 (COVID-19)

Introduction: Coronavirus disease 2019 (COVID-19) is a respiratory infection that has become a global pandemic. Approximately 5% of all sufferers of this disease require an intensive care unit, with Acute Respiratory Distress Syndrome (ARDS) as one of the main complications with a mortality ratio reaching 94%. COVID-19 which disrupts the respiratory system requires adequate management, especially in ventilation or oxygenation to reduce the risk of multi-organ damage. The author discusses this topic in this literature review. Results: Ventilation management in COVID-19 patients must adhere to the principles of Safe (for staff and patients), Accurate (preventing unusual techniques), and Swift (fast). Airway management in COVID-19 patients has a very high risk because of the large opportunity for aerosolization to occur. Providing ventilation (oxygenation) to patients with COVID-19 has many options, ranging from the nasal cannula, face mask, rebreathing masks, Venturi Mask, Non-rebreathing Mask (NRM), High Flow Nasal Cannula, Non-Invasive Ventilation (NIV), to intubation with mechanical ventilation. Regarding intubation, until now there is no specific protocol, especially regarding disagreements about early or late intubation. Conclusion: The choice of oxygen administration technique, as well as the decision to intubate, largely depended on the discretion of the anesthetist who is present and assesses it according to the individual needs and clinical status of the patient.Pendahuluan: Penyakit Coronavirus 2019 (COVID-19) merupakan infeksi saluran pernafasan  yang telah menjadi pandemi global. Sekitar 5% dari seluruh penderita penyakit ini memerlukan unit perawatan intensif, dengan Acute Respiratory Distress Syndrome (ARDS) sebagai salah satu komplikasi utama dengan rasio kematian mencapai 94%. COVID-19 yang menyebabkan gangguan terutama pada sistem pernafasan memerlukan tatalaksana yang adekuat, khususnya dalam ventilasi atau oksigenasi untuk mengurangi risiko kerusakan multi organ. Penulis membahas topik tersebut pada tinjauan pustaka ini. Hasil: Tatalaksana ventilasi pada pasien COVID-19 harus memegang prinsip Safe (untuk petugas dan pasien), Accurate (mencegah teknik yang tidak biasa), serta Swift (cepat). Manajemen jalan nafas pada pasien COVID-19 memiliki risiko yang sangat tinggi karena besarnya peluang aerosolisasi yang terjadi. Pemberian ventilasi (oksigenasi) pada pasien dengan COVID-19 memiliki banyak pilihan, mulai dari nasal cannula, face mask, rebreathing masks, Venturi Mask, Non-rebreathing Mask (NRM), High Flow Nasal Cannula, Non Invasive Ventilation (NIV), hingga intubasi dengan ventilasi mekanik. Mengenai intubasi, hingga saat ini tidak terdapat protokol khusus, terutama terkait silang pendapat tentang early atau late intubation. Simpulan: Pemilihan teknik pemberian oksigen maupun keputusan intubasi sangat bergantung pada kebijaksanaan dari dokter anestesi yang hadir dan menilai sesuai dengan kebutuhan individu dan status klinis pasien

Correlation Between Total Cholesterol Level with Blood Pressure of Hypertensive Patients in Kalidoni, Palembang

Background: Hypertension is the main problem worldwide. It has strong relationship with other component of metabolic syndrome, namely dyslipidemi. Authors are analyzing the correlation between total cholesterol level and blood pressure in the hypertensive patient at Kalidoni Primary Health Center, Palembang, Indonesia.Methods: This was a cross-sectional study involving 82 adult hypertensive patients. Data were collected from the medical record of patients who are visiting Kalidoni Primary Health Center in December 2019-January 2020. Demographic data, blood pressure, and total cholesterol level were gained. Obtained data are analyzed descriptively (frequency distribution) and analytically (correlation using Pearson or Spearman method).Result: Significant positive correlations were observed between total cholesterol level and systolic blood pressure (r=0.509, p=0.000) in addition to body weight and diastolic blood pressure (r=0.279; p=0.011).Conclusion: Blood cholesterol level had a significant correlation with moderate strength for determining systolic blood pressure level in hypertensive patients

Vogt-koyanagi-harada disease: A potentially debilitating diagnosis of exclusion

Background: Vogt-Koyanagi-Harada (VKH) disease is a systemic autoimmune granulomatous disease that targets melanocyte-rich tissue with potentially visually-threatening outcome for patients. It is manifested in eyes, inner ears, skin, and hair. Aim: This review aims to give a brief information about VKH disease, especially regarding the diagnosis and treatment. Conclusion: VKH disease is a diagnosis of exclusion, a comprehensive history taking and physical examinations are required for prompt treatment using immunosuppressive agent to improve patient outcomes. Clinical Significance: It is possible to treat this condition by applying diagnostic criteria. This requires a very thorough review of possible differential diagnosis and should then be treated with high corticosteroid immunosuppressive drugs. This is solely responsible for stopping the visual impairment and recurrence of the disease

Debunking the myth of using “quiet” in clinical departments : an integrative overview of available literature

Funding Information: We would like to acknowledge the support and contributions of The ECOMSIR Collaborative (European Collaboration of Medical Students in Research), a non-profit, non-governmental student collaboration. The support of Riga Stradins University (RSU) is also greatly acknowledged.publishersversionPeer reviewe

Peanut (Arachis hypogaea) Shells Extract and Apis dorsata Honey Reduce Matrix Metalloproteinase-3 in Monosodium Iodoacetate-Induced Osteoarthritic Rats

Background: Osteoarthritis is the most common degenerative joint disease worldwide but its treatment can cause serious adverse events. Ethanol extract of peanut shells contains luteolin functioned as its main anti-inflammatory and chondroprotective agent. Apis dorsata honey also contains anti-inflammatory and antioxidant agent, especially from Tualang honey type. Both have the potential to reduce inflammation and prevent articular degradation in osteoarthritis.Objective: This study aims to determine the effect of peanut shells extract and Apis dorsata honey on matrix metalloproteinase-3 (MMP-3) level in monosodium iodoacetate-induced (MIA) osteoarthritic rats.Methods: In this in vivo study, female Wistar rats (n=27) were randomly divided to nine groups containing three rats each. Treatment was given to group 1, 2, and 3: Tualang honey (TH) 25% + peanut shells extract (PSE) with 1%, 5%, and 10% concentration; group 4, 5, and 6: TH 50% + PSE with 1%, 5%, and 10% concentration; group 7: diclofenac sodium (positive control); group 8: aquadest (negative control); and group 9: aquadest (normal) for 10 days. We induced knee osteoarthritis by intraarticular injection of MIA in day 4. Anti-inflammatory and chondroprotective activities were evaluated with MMP-3 ELISA.Results: The mixture of peanut shells extract and Apis dorsata honey significantly reduced MMP-3 level in group 1 (331.12 pg/ml), group 2 (291.73 pg/ml), group 3 (266.58 pg/ml), group 4 (274.15 pg/ml), group 5 (251.12 pg/ml), and group 6 (220.52 pg/ml) after 10 days of treatment. MMP-3 level was also evaluated in group 7 (169.61 pg/ml), group 8 (413.55 pg/ml), and group 9 (39 pg/ml). Compared to the negative control group, treatment and diclofenac groups showed significant effect in reducing MMP-3 level in patello-femoral articular cartilage.Conclusion: Peanut shells extract and Apis dorsata honey showed antiinflammatory and chondroprotective effect by reducing MMP-3 level in MIA-induced osteoarthritic rats

Biokerosene Analysis from the Latex Distillation as an Alternative Solution to National Energy Crisis

Energy crisis is ready to whack, according to the fact that about 66% of the earth's fuel comes from fossils. Urgency for alternative fuels discovery is increasing, one of which is natural rubber latex. This material has potential as an alternative fuel because of its high hydrocarbon content. This study was to determine rubber latex activity as biokerosene. In this study, distillation of fresh natural rubber latex was performed and process produces an average of 0.196 L of distillate per 0.5 kg of latex. The distillate was separated to obtain pure biokerosene. From latex biokerosene analysis, it shows yellow color, strong odor, nonpolar properties, flammability, yellow flame color and black smoke, 0.87399 g/cm3 density, Rf=0.641 (4% methanol as mobile phase) and Rf=0.883 (N-hexane and acetone as mobile phase) of the thin layer chromatography. It can be concluded that latex has the potential as a biokerosene and can be an alternative solution against national energy crisis.</p

The global response : how cities and provinces around the globe tackled COVID-19 outbreaks in 2021—authors’ reply

We would like to thank Ngo et al., for expressing their interest in our work. In our recent work, we looked at the preventive measures that were undertaken by various cities and provinces across the globe to prevent the spread of COVID-19 infection. In their correspondence, Ngo et al., have raised potential concerns in association with the data presented and certain definitions used in the paper. Upon receipt of their letter, we revisited our data sources. Herein, we provide a point-by-point response to the concerns raised by Ngo et al

Health-Related Quality of Life among Adult Patients with Ehlers-Danlos Syndrome: A Systematic Review and Meta-Analysis

Background: Ehlers-Danlos Syndrome (EDS) is a serious chronic condition that leads to diminished quality of life and psychological problems. The current study aimed to systematically reviewed the existing literature on EDS patients' health-related quality of life (HRQoL), calculate mean HRQoL value, and determine the association between demographical and publication-related characteristics with HRQoL.  Methods: Four electronic databases were used to identify papers on HRQOL in adults with EDS (Scopus, Medline (by Pubmed), Epistemonikos, and Web of Science). A random-effects meta-analysis was also performed on the 36-item Short Form Survey (SF-36) measure. Results: We contained 37 studies that fulfilled the inclusion criteria. According to the SF-36 meta-analysis, EDS patients and the general population had significant differences in all HRQoL components (p0.01). In EDS patients, the Physical Component Summary (35.34/100) was more seriously impacted than the Mental Component Summary (45.21/100) in these patients. Conclusion: Individuals with EDS have significantly lower HRQoL in all aspects compared to the general population, with the physical component of wellbeing being the most pronounced disparity. Future research should look into the impact of different patient characteristics, evaluate the complications of EDS and their effects on wellbeing, and develop multiple intervention strategies to improve HRQoL